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目的 通过检测同步放化疗宫颈癌组织及同期非宫颈癌组织中乏氧诱导因子-1α(HIF-1α)和α-平滑肌肌动蛋白(α-SMA)的表达水平,探讨二者在宫颈癌组织中的临床意义.方法 采用免疫组织化学法对河北北方学院附属第一医院2013年1月至2014年1月收治的宫颈鳞癌组织68例和同期非宫颈癌组织(包括正常宫颈组织、子宫肌瘤或宫颈上皮内瘤变)56例行HIF-1α和α-SMA检测.结果 HIF-1α和α-SMA在宫颈癌和非宫颈癌组织中的阳性表达率分别为58.8％(40/68)、39.3％(22/56)和54.4％(37/68)、35.7％(20/56),差异有统计学意义(P＜0.05).在宫颈癌组织中HIF-1α与α-SMA表达呈正相关性(r=0.376,P=0.001).HIF-1α阳性表达与国际妇产科联盟(FIGO)分期(r=0.371,P=0.004)、淋巴结转移(r=0.243,P=0.039)、腹主动脉旁淋巴结转移(r=0.286,P=0.014)、血清鳞状上皮细胞癌抗原(SCC-Ag)(r=0.271,P=0.020)密切相关,而与年龄、肿瘤直径无相关性(P＞0.05);α-SMA阳性表达与宫颈癌淋巴结转移(r=0.363,P=0.001)、腹主动脉旁淋巴结转移(r=0.271,P=0.020)、SCC-Ag(r=0.272,P=0.020)相关,而与年龄、FIGO分期和肿瘤直径无相关性(P＞0.05).HIF-1α和α-SMA阳性近期放疗有效率分别为27.5％(11/40)和21.6％(8/37),阴性有效率为64.3％(18/28)和48.4％(15/31),差异均有统计学意义(P＜0.05).68例中位随访时间60个月,5年总生存率为52.9％ (36/68).HIF-1 α和α-SMA阳性患者的5年生存率为42.5％(17/40)和40.5％(15/37),阴性患者的5年生存率为67.9％(19/28)和67.7％ (21/31),差异有统计学意义(x2=4.091和4.573,P=0.043和0.032).结论 HIF-1α、α-SMA的升高可作为预测宫颈癌同步放化疗后发展和预后的指标.“,”Objective To examine the expression levels of hypoxia inducible factor (HIF)-1α and α-smooth-muscle actin (SMA) in both cervical cancer tissues with concurrent chemoradiotherapy and non-cervical cancer tissues,and assess the clinical significance in cervical cancer.Methods The immune-histochemistry was used to detect HIF-1α and α-SMA in 68 cases of cervical cancer tissues and 56 cases of non-cervical cancer tissues (including normal cervical tissues,hysteromyoma and cervical intraepithelial neoplasias) from January 2013 to January 2014 in the First Affiliated Hospital of Hebei Northern University.Results The positive expression rates of HIF-1α and α-SMA in cervical cancer tissues and non-cervical cancer tissues were 58.8％ (40/68),39.3％ (22/56) and 54.4％ (37/68),35.7％ (20/56) respectively;the differences were significant statistically (P＜ 0.05).The expression of HIF-1α was positively correlated with the expression of α-SMA protein in cervical cancer tissues (r =0.376,P =0.001).The positive expression of HIF-1α was closely related to International Federation of Gynecology and Obstetrics (FIGO) stages (r =0.371,P =0.004),lymph node metastasis (r =0.243,P =0.039),abdominal aortic parathyroid lymph node metastasis (r =0.286,P =0.014) and serum squamous cell carcinoma antigen (SCC-Ag) (r =0.271,P =0.020),but it was not correlated with age and tumor size (P ＞ 0.05).The positive expression of α-SMA was associated with lymph node metastasis (r =0.363,P =0.001),abdominal aortic parathyroid lymph node metastasis (r =0.271,P =0.020) and SCC-Ag (r =0.272,P =0.020),but it was not correlated with age,FIGO stage and tumor size (P ＞ 0.05).The shortterm effect rates of concurrent chemoradiotherapy in cervical cancer tissues with positive and negative expression of HIF-1α and α-SMA were 27.5％ (11/40),21.6％ (8/37),and 64.3％ (18/28) and 48.4％ (15/31),and there were statistical differences (P ＜ 0.05).The medial follow-up time of 68 cases was 60 months,and the 5-year survival rate was 52.9％ (36/68).The 5-year survival rates of the patients with positive expression of HIF-1α and α-SMA were 42.5％ (17/40) and 40.5％ (15/31),the 5-year survival rates of the patients with negative expression of HIF-1α and α-SMA were 67.9％ (19/28) and 67.7％ (21/31),and the differences were statistically significant separately (x2 =4.091 and 4.573,P =0.043 and 0.032).Conclusions The elevation of HIF-1α and α-SMA may be used to predict the development and prognosis of cervical cancer with concurrent chemoradiotherapy.